NICHD sponsored and coordinated the 1988 survey to provide population-based data on children's health. One major collaborative effort analyzed childhood injury risk factors to support effective targeting of interventions since injury is the leading cause of death for children in the U.S. This is the first study to demonstrate that non-fatal injury causes differed considerably from fatal causes, with considerable variation of risk factors by age and socioeconomic characteristics. Analysis of injuries in preschool children by child care patterns showed that use of non-guardian care did not increase risks except for the youngest children of poor, low education mothers who use multiple part-time places of care of all types (center-based, care in their own home or homes of others). Increasing hours in center-based care seemed to lower both total and serious injury risks for children ages 4-5 years. Also, older children of women who are problem drinkers, or of two parents who are both problem drinkers, are at higher injury risk. Another risk factor analysis showed that sports and recreation account for 36% of all medically attended injuries from all causes. Analysis of effects of access to medical care showed that children without medical care coverage (health insurance or Medicaid) were 30 to 40% less likely to receive medical attention for either total or services injuries compared to children with medical care coverage. The latest studies have shown that children in single adult households are at increased risk regardless of other factors such as poverty or race. Other projects are focused on factors affecting risks of frequent ear infections, deafness or trouble hearing and related conditions. Effects of maternal smoking on ear infections and respiratory conditions show increased risks.